[Hiring] Coder III @UPMC

Role Description

UPMC Corporate Revenue Cycle is hiring a Coder III to join our Coding Department! This position will be a work-from-home position, working Monday through Friday during business hours.

In this role, you will:

• Monitor and respond to accounts on Pre-Bill edit and error reports.
• Assist with training other coders as requested.
• Perform PHC4 coding corrections.
• Provide feedback to coders who made errors.
• Monitor the Daily Cirius Error report to ensure that there are zero accounts exceeding the expected completion timeframe.
• Review and respond to the Pre-Bill Edit report issues to ensure timely billing.
• Assist with special projects as requested.

We are seeking experienced Coders with a strong background in Interventional Radiology (IR) and Interventional Cardiology (IC) CPT coding. Qualified applicants should possess a minimum of three years of CPT coding experience.

If you are ready to take the next step in your coding career, look no further!

Responsibilities:

• Determine diagnoses that were treated, monitored, and evaluated and procedures done during the episode of care and assign appropriate codes.
• Review appropriate documents in the patients' charts to accurately assign a diagnosis and/or procedure.
• Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG/APC/ASC or payment tier under the Prospective Payment system or DSM IV methodology to guarantee accurate reimbursement on UPMC patients.
• Make forward progress within the training period toward meeting coding accuracy standards of 98% within the first year of employment.
• Meet appropriate coding productivity standards within the time frame established by management staff.
• Code all diagnoses and procedures by assigning and verifying the proper ICD-10-CM and CPT codes (DSM IV if applicable).
• Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding.
• Adhere to internal department policies and procedures to ensure efficient work processes.
• Actively participate in monthly coding meetings and share ideas and suggestions for operational improvements.
• Maintain continuing education by attending seminars, reviewing updated CPT assistant guidelines and updated coding clinics.
• Complete work assignments in a timely manner and understand the workflow of the department.
• Maintain daily productivity statistics and submit a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and the number of minutes/hours spent on non-coding tasks.
• Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to accurately complete the coding process.
• Consult with DRG Specialists when applicable during query process.
• Refer problem accounts to appropriate coding or management personnel for resolution.
• Review coding for accuracy and completeness before submission to billing system utilizing CCI edits.
• Utilize standard coding guidelines, principles, and coding clinics to assign the appropriate ICD-10-CM, CPT, and DSM IV codes for all record types to ensure accurate reimbursement.
• Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed.
• Utilize computer applications and resources essential to completing the coding process efficiently, such as hospital information systems (Medipac/SMS/Meditech), encoders, and electronic medical record repositories.
• If applicable, abstract required medical and demographic information from the medical record and enter the data into the appropriate information system to ensure accuracy of the database.
• Correct any data to be in error after reviewing the medical record and comparing with system entries.

Qualifications

• High School or GED equivalent.
• Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program with a curriculum that includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-10-CM, and CPT Coding Guidelines and Procedures.
• Three years hospital coding experience.
• CIRCC (Certified Interventional Radiology and Cardiovascular Coder) credential is preferred.

Requirements

• Requires CCS or RHIT or RHIA or Certified Professional Coder certification.
• Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Nationally Registered Certified Coding Specialist (NRCCS) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT).
• Certified Professional Coder (CPC).
• Act 34.

Company Description

UPMC is an Equal Opportunity Employer/Disability/Veteran.